SB1129
Protecting The Doctor-Patient Relationship
When A Managed Care Company Changes Its Contract To Remove Your Doctor
In 1998 Senator Byron Sher's SB 1129 was enacted. It provides for a
transition period between doctor and patient when a managed care company
removes a from the company's provider panel, unless the doctor is removed
for quality of care reasons. The transition period would last until the
course of care for the condition is completed or until the patient may be
safely transitioned to a new provider, whichever happens first. The California
Psychiatric Association supports SB 1129. The bill can be accessed through
the California Senate's home page, or through the government link on this
web page.
When most consumers choose a health plan, they specifically review whether
their physician is on the health care plan's panel. If the carrier then
determines to remove the patient's physician, this bill would provide a
limited period of time for the patient to find a new doctor, or to switch
health plans so that the consumer can keep the same physician.
A provision for a transition is particularly important for psychiatric
patients. For example, many psychiatric medications take a long period of
time to be effective, and may require close monitoring both for effectiveness
and side effects. The psychiatrist and the patient need a time period during
which a reasonable transition can occur to a plan doctor, or the patient
can change to a plan which has the psychiatrist on its panel. Additionally,
the treatment of the patient can be set back by several months or longer
when treatment is summarily changed.
But many other patients face difficulties when the company changes the
doctors on its panel. If you, a friend or family have faced a situation
as a patient where your doctor has been removed by your managed care provider's
panel and it caused you difficulties in getting your disease or injury treated
well, please send information on your story to us to use in monitoring compliance
of the HMOs with this new law.
Send it to our e-mail address at calpsych@worldnet.att.net,
or call us at (916)-442-5196 to discuss it with us.
If you e-mail the example, please give us an address or telephone number
where we can reach you in case we need more information.
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